• Pierre Labroca, Gérard Chiesa, Isabelle Laroyenne, Léo Borrini, Rémi Klotz, Quoc Phan Sy, Marie-Christine Cristina, Anne Brunon Martinez, Pierre-Edouard Bollaert, Jean Paysant, and Jérémie Lemarié.
• Réanimation médicale, hôpital central, C.H.R.U. de Nancy, Nancy, France.
• J Crit Care. 2019 Oct 1; 53: 231-235.

PurposeTo assess health-related quality of life (HRQOL) following rehabilitation of amputees suffering symmetric peripheral gangrene (SPG) after septic shock.Material And MethodsA retrospective cohort study was conducted in nine French specialized rehabilitation centers. Thirty-two ICU adult patients hospitalized between 2005 and 2015 for septic shock who additionally presented with SPG resulting in at least two major amputations were enrolled. HRQOL was assessed by EQ-5D-3 L questionnaire.ResultsAll patients (mean ICU length of stay 39 ± 22d, SAPS II 58 ± 18) had both lower limbs amputated and 84% were quadruple amputees. HRQOL, assessed 4.8 ± 2.8 years after amputation, was inferior to the French reference. However, patients' self-rated health status was similar to the reference at the time of HRQOL assessment. The main factor of impaired HRQOL was intense phantom pain, not the mobility or self-care dimensions of EQ-5D. All patients except one preferred to be treated again for SPG despite disability.ConclusionICU survivors referred to rehabilitation centers after SPG-related amputations had impaired HRQOL. At the time of HRQOL assessment, they considered themselves in good health and preferred to be treated again despite disability. Appraisal of long-term functional outcome should not be used to guide end-of-life decision-making in this situation.Copyright © 2019. Published by Elsevier Inc.

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